Percutaneous placement of Hickman catheters for prolonged venous access.

The Hickman catheter is well established as a safe, reliable means of venous access in a variety of clinical situations. Although the technique for placement by surgical cutdown in the cephalic or external jugular vein is standardized, our experience placing 102 catheters in the last 40 months has led us to evolve and adopt a percutaneous method that we have now applied to almost all catheter placements. Operative time has been dramatically reduced, patient discomfort minimized, and no change in short- or long-term morbidity had been noted. The procedure has been described in detail, and our overall experience with placement of the Hickman catheter in a variety of clinical situations has been reviewed. We now consider this percutaneous technique to be the primary method of Hickman catheter placement unless specifically contraindicated.